The Rising Demand of Emergency General Surgery: A 15-Year Study at a Metropolitan New Zealand Hospital

Emergency general surgery (EGS) services are under increasing pressure in New Zealand and internationally. This study examined trends in EGS volume, incidence, patient complexity, and system performance over 15 years at North Shore Hospital, Waitematā, New Zealand.

We conducted a retrospective cohort study of adult patients (≥ 16 years) undergoing emergency general surgical procedures at North Shore Hospital between 2010 and 2024. Annual procedure volumes, incidence rates using census-derived catchment populations, patient demographics, procedure type and key system performance indicators were analysed over time.

A total of 39 996 emergency general surgical procedures were performed. Case volume increased by 32.3% over the study period, with a corresponding rise in total operative minutes. The overall population of Waitemata increased from 524 610 to 670 174 people (a 27.8% increase, 1.65% per year). The overall procedure incidence rate increased modestly (453.1 vs. 469.1 per 100 000 person-years) but did not reach statistical significance. The median age of surgical patients increased more rapidly than the underlying population. The proportion of patients with ASA ≥ 3 rose from 23.4% to 34.5%. Median time from booking to surgery increased from 7 to 16 h, while length of stay remained stable.

This study demonstrated a significant increase in the emergency general surgical workload at a large metropolitan hospital in New Zealand, with population growth as the primary driver. It also demonstrates that the patients are ageing and becoming increasingly medically complex. These findings highlight the need for proactive workforce planning and service design.